Paediatric Foot Problems

Question 1

where done bone growth occur from?

Answer 1

physis

Question 2

factors that affect the growth from the physis

Answer 2

diet
vitamins A and D
injury
illness
hormones (GH)

Question 3

what is genu varum

Answer 3

knees are far away

Question 4

when is genu varum normal?

Answer 4

<2 years

Question 5

when can persistence of genu varum be normal?

Answer 5

if it runs in families

Question 6

when is genu varum abnormal?

Answer 6

unilateral
severe >2SD
painful

Question 7

pathologies of genu varum

Answer 7

skeletal dysplasia
Ricket's
tumours (enchondroma)
Blount's disease
trauma

Question 8

what is Blount’s disease

Answer 8

growth arrest of medial tibial physis

Question 9

what is genu valgum?

Answer 9

knees knock together

Question 10

when does genu valgum peak?

Answer 10

3 1/2 years

Question 11

when to refer genu valgum?

Answer 11

pain
severe
beyond 11 years

Question 12

pathologies of genu valgum

Answer 12

tumours (enchondroma, osteochondromas)
ricket’s
NF

Question 13

what are three potential causes of intoeing?

Answer 13

1. femoral neck anteversion
2. internal tibial torsion
3. metatarsus adductus

Question 14

presentation of femoral neck anteversion

Answer 14

child sits in W position

predisposes to patellofemoral problems

Question 15

what age does internal tibial torsion present?

Answer 15

1-3 years

most resolve by 6

Question 16

presentation of internal tibial torsion

Answer 16

foot sits outward of hip when kneeling

Question 17

management of metatarsus adductus

Answer 17

serial casting can help but most resolve

Question 18

is everyone born with flat feet?

Answer 18

yes

Question 19

when does the medial arch in the foot develop?

Answer 19

tibialis posterior strengthens

Question 20

management of flat feet

Answer 20

usually asymptomatic but can do stretching

Question 21

when is flat feet pathological?

Answer 21

tarsal coalition

this requires surgery

Question 22

when do curly toes tend to resolve?

Answer 22

by age 6

Question 23

what to consider if curly toes persist?

Answer 23

flexor tenotomy

Question 24

what is talipes equinovarus?

Answer 24

club foot

Question 25

define club foot

Answer 25

this is a congenital deformity with abnormal alignment of the joints between the talus, calcaneus and navicular

Question 26

what does the club foot alignment result in?

Answer 26

contractures of soft tissue causing ankle equinus, supination of forefoot and varus alignment of forefoot

Question 27

management of club foot

Answer 27

splintage using Ponseti technique

most also require Achilles tenotomy

Question 28

what is cavus feet?

Answer 28

abnormally high arch

Question 29

what is rockerbottom feet?

Answer 29

sole of foot in flexion